Ultrasound guided erector spinae plane block as a cause of unintended motor block

Rev Esp Anestesiol Reanim (Engl Ed). 2018 Dec;65(10):589-592. doi: 10.1016/j.redar.2018.05.009. Epub 2018 Jul 9.
[Article in English, Spanish]

Abstract

Erector spinae plane block (ESPB) as postoperative analgesia method has been successfully carried out in several surgical interventions. Postoperative pain treatment for cesarean section is considered one of the important challenges for anesthesiologists due to the risk of chronic pain development and even pospartum depression. Regional anesthesia techniques were effectively used to prevent the pain together with multimodal analgesia regimes in cesarean section. Formerly, successful erector spinae plane block was documented as postoperative analgesia treatment for cesarean section; however, no motor weakness was recorded as a side effect. In this case report, we present an unexpected motor weakness as a side effect of the erector spinae plane block after cesarean delivery operation in a 29 year old patient. To our knowledge, this is the first report of motor weakness related to the ESPB.

Keywords: Anestesia obstétrica; Anestesia regional; Obstetric anesthesia; Regional anesthesia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Analgesia, Obstetrical / adverse effects*
  • Bupivacaine / adverse effects
  • Bupivacaine / pharmacokinetics
  • Cesarean Section / adverse effects
  • Diffusion
  • Female
  • Gait Disorders, Neurologic / etiology*
  • Humans
  • Leiomyoma / surgery
  • Lidocaine / adverse effects
  • Lidocaine / pharmacokinetics
  • Lumbosacral Plexus / drug effects
  • Lumbosacral Plexus / physiopathology
  • Muscle Weakness / etiology*
  • Nerve Block / adverse effects*
  • Nerve Block / methods
  • Pain, Postoperative / prevention & control
  • Paraspinal Muscles / drug effects*
  • Paraspinal Muscles / innervation
  • Paraspinal Muscles / physiopathology
  • Pregnancy
  • Pregnancy Complications, Neoplastic / surgery
  • Ultrasonography, Interventional
  • Uterine Neoplasms / surgery

Substances

  • Lidocaine
  • Bupivacaine